Depression & Anxiety: Two In One?

Depression and anxiety often occur together. We have all experienced feelings of anxiety or depression or both in our lives, because life can be challenging and overwhelming. The saying “sometimes bad things happen to good people” is a good example of how life can put obstacles in our way. Loss of a job, loss of a spouse or family member, financial issues, or divorce or marital or relationship issues can lead to stress, sadness, anxiety or depression. While there are many differences between an anxiety disorder and depression, there are also many similarities.

Depression

Feeling tearful with or without a reason

Feeling like crying or crying often

Extreme feelings of sadness for a long period of time (usually 2 weeks or more)

Social activities or being friends are no longer enjoyable

Thinking or feeling life is hopeless or feeling helpless in one’s life

Continued feelings of irritability or anger

Can become snappy or have angry outbursts

Feelings of shame, guilt and worthlessness

Low levels of focus, concentration or difficulty making decisions

Noted changes in appetite, including weight gain or weight loss

Changes in sleep pattern, such as sleeping too much, too little, not falling asleep, waking early, sleeping most of time but still feeling tired

Suicidal ideation, plans or attempts

Beginning use or increase of use of alcohol or drugs

Anxiety

Feelings of panic or anxiousness with or without cause

Changes in sleep pattern, such as sleeping too much, too little, not falling asleep, waking early, sleeping most of time but still feeling tired

Numbness or tingling in the hands or feet, feeling like electricity running through extremities

Nausea, vomiting, pain in the stomach

Muscle tension, pain in neck, arms or shoulders

Dizziness

Overlap Exists

The symptom lists for depression and anxiety demonstrate some overlap in symptoms. It is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder. "Very often, we find that people have more than one condition -- both depression and anxiety disorder," says Charles Goodstein, MD a professor of psychiatry at New York University School of Medicine, with a clinical practice in Tenafly, N.J. "As a matter of fact, it's very hard to find patients who are depressed who don't also have anxiety. It's equally hard to find people with anxiety who don't have some depression."

Anxiety can trigger depression and depression can trigger anxiety, so anxiety and depression often co-occur, and both disorders impact the brain in similar ways. Anxiety and Depression are both found to be linked with a depletion of the neurotransmitter in the brain, serotonin - Serotonin is responsible for making the person’s mood and feeling of mental well being. A depletion in serotonin can cause depressive symptoms, anxiety symptoms, or both. There is also evidence of a change in the brain’s stress response system, which is controlled by the amygdala, and this change is an increase in reactivity in the amygdale, which has been reported in multiple research studies.

The DifferencesWhile some of the similarities are apparent, there are also some differences that make distinguish each disorder from the other. A person with depression feels overwhelmingly sad, blue, lack of energy, etc for long periods of time, and these feelings are continuous and generally last 2 weeks or longer. For someone with anxiety, they may feel anxious throughout the day or have days of chronic stress or anxiety, but anxious feelings can decrease at points throughout the day or extinguish for a day or a few days and then return. In addition, anxiety can be accompanied by panic attacks that include feeling like the person is having a heart attack or going insane. These panic attacks can create more feelings of anxiety and even phobias, but this is not true with depression.

While there are many overlapping symptoms of depression and anxiety, they are different disorders. In addition, depression can trigger anxiety and anxiety can trigger depressive symptoms. But each disorder has its own causes and its own emotional and behavioral symptoms. Both can cause profound impact on a person’s life, so professional help is recommended for both depression and anxiety, and they can also treat each disorder simultaneously.

- Kim B.

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